Provider Demographics
NPI:1336574540
Name:CUOCCIO, SUSAN (MSED)
Entity Type:Individual
Prefix:PROF
First Name:SUSAN
Middle Name:
Last Name:CUOCCIO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2512
Mailing Address - Country:US
Mailing Address - Phone:516-326-2004
Mailing Address - Fax:
Practice Address - Street 1:56 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2512
Practice Address - Country:US
Practice Address - Phone:516-326-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY978127001174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator